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Microvascular abnormalities in dry eye patients.

Wan Chen1, Yuqing Deng2, Hong Jiang3

  • 1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.

Microvascular Research
|March 31, 2018
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Summary

Dry eye disease (DED) is associated with significant microvascular changes in the conjunctiva. Patients with DED exhibit increased blood flow velocity, vessel density, and diameter compared to healthy individuals.

Keywords:
Blood flow velocityDry eye diseaseFunctional slit lamp biomicroscopy (FSLB)Non-invasive bulbar conjunctival microvascular perfusion maps (nMPMs)

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Area of Science:

  • Ophthalmology
  • Microcirculation Research
  • Dry Eye Disease Pathophysiology

Background:

  • Dry eye disease (DED) is a prevalent condition affecting the ocular surface.
  • Microvascular alterations may play a role in the pathophysiology of DED.
  • Understanding conjunctival hemodynamics is crucial for diagnosing and managing DED.

Purpose of the Study:

  • To evaluate conjunctival blood flow velocities and microvascular network density in patients with DED.
  • To compare microvascular parameters between DED patients and healthy controls.
  • To investigate the relationship between microvascular alterations and DED severity.

Main Methods:

  • Functional slit-lamp biomicroscopy was used to assess the temporal bulbar conjunctiva in 25 DED patients and 25 controls.
  • Key vascular variables measured included blood flow velocity (BFV), blood flow rate (BFR), microvascular network density (fractal dimension, Dbox), and vessel diameter.
  • Fractal analysis using the box counting method quantified vessel density.

Main Results:

  • DED patients showed significantly higher bulbar BFV (0.59 vs. 0.47 mm/s) and BFR (169.5 vs. 107.2) compared to controls (P<0.001).
  • Microvascular network density (Dbox) was higher in DED patients (1.65 vs. 1.60, P<0.05), and vessel diameter was larger (21.8 vs. 17.9 μm, P<0.001).
  • A positive correlation was found between Dbox and the Ocular Surface Disease Index (OSDI) in DED patients (r=0.54, P=0.008).

Conclusions:

  • Microvascular alterations, including increased blood flow velocity, higher vessel density, and larger vessel diameter, are present in the bulbar conjunctiva of DED patients.
  • These findings suggest that impaired conjunctival microcirculation is a characteristic feature of DED.
  • Conjunctival microvascular changes may contribute to DED symptoms and severity.